Mìžnarodnij Endokrinologìčnij Žurnal (Sep 2014)
Peculiarities of Changes in Daily Blood Pressure and Its Variability in Patients with Essential Hypertension and Diabetes Mellitus Type 2
Abstract
The aim of the study was to determine the peculiarities of changes in daily blood pressure (BP) and its variability in patients with essential hypertension (EH) and diabetes mellitus type 2 (DM type 2). 150 patients of average age 53.4 ± 5.3 years old were examined. Patients were divided into groups: 30 healthy persons, 30 patients with DM type 2, 30 patients with EH and 60 patients with EH combined with DM type 2. Daily BP monitoring (DBPM) was performed using the apparatus ABPM-04. The patients with DM type 2 compared to healthy persons were found to have significantly increased (p < 0.05) daily, daytime and night diastolic BP (DBPdaily, DBPnight, DBPday). Time indexes of night systolic blood pressure (SBPnight) and daytime systolic blood pressure (SBPday) were elevated by 2.01 and 1.80 times. There was significantly increased rate pressure product (RPP) that was a marker of a high level of load with high blood pressure in those patients. In patients with essential hypertension combined with diabetes mellitus type 2 associated with II stage hypertension in comparison with a group with essential hypertension, the parameters of DBPM did not much differ, and the indices of SBPdaily, SBPday, SBPnight, were significantly (p < 0.02) reduced, and the rate of DP was significantly (p < 0.05) higher versus the group of comparison. In patients with III stage hypertension the parameters of night blood pressure decrease (SBP, DBP) were significantly higher. There were significantly (p < 0.05) elevated the DP values, daily and night blood pressure, that was a marker of unfavorable hemodynamic parameters during the day and especially at night. In patients with essential hypertension combined with diabetes type 2 dipper and non-dipper circadian rhythms prevailed. They had higher values of SBP variability in the daytime, load with high blood pressure in the daytime and at night; the degree of the insufficient night reduction and morning increase of BP. Those parameters were significantly in non-dipper circadian rhythm.
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